title: The effect of emergency department crowding on education: blessing or curse?
abstract: Emergency department (ED) crowding is a national crisis that contributes to medical error and system inefficiencies. There is a natural concern that crowding may also adversely affect undergraduate and graduate emergency medicine (EM) education. ED crowding stems from a myriad of factors, and individually these factors can present both challenges and opportunities for education. Review of the medical literature demonstrates a small body of evidence that education can flourish in difficult clinical environments where faculty have a high clinical load and to date does not support a direct deleterious effect of crowding on education. To provide a theoretical framework for discussing the impact of crowding on education, the authors present a conceptual model of the effect of ED crowding on education and review possible positive and negative effects on each of the six recognized Accreditation Council for Graduate Medical Education (ACGME) core competencies.
authors.affiliation: Department of Emergency Medicine, Emory University, Atlanta, GA, USA. pshayne@emory.edu
authors.forename: Philip
authors.initials: P
authors.lastname: Shayne
authors.forename: Michelle
authors.initials: M
authors.lastname: Lin
authors.forename: Jacob W
authors.initials: JW
authors.lastname: Ufberg
authors.forename: Felix
authors.initials: F
authors.lastname: Ankel
authors.forename: Kelly
authors.initials: K
authors.lastname: Barringer
authors.forename: Sarah
authors.initials: S
authors.lastname: Morgan-Edwards
authors.forename: Nicole
authors.initials: N
authors.lastname: DeIorio
authors.forename: Brent
authors.initials: B
authors.lastname: Asplin
mesh_terms: D035843:Biomedical Research; D002983:Clinical Competence; D003441:Crowding; D004503:Education, Medical, Graduate / Q000592:standards; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D017145:Models, Educational; D011785:Quality Assurance, Health Care; D014481:United States